How much rates vary
Facilitymedian $26 · 10th to 90th $8 to $74Professionalmedian $5 · 10th to 90th $4 to $9
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $5.13 Median $10.23 Typical High $41.69 | Facility | None | $5.13 | $10.23 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $4.90 Median $5.37 Typical High $10.00 | Professional | None | $4.90 | $5.37 | $10.00 |
Ambetter Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | None | $5.01 | $5.01 | $5.01 |
BCBS Texas Setting Facility Modifier None Typical Low $8.91 Median $26.30 Typical High $53.70 | Facility | None | $8.91 | $26.30 | $53.70 |
BCBS Texas Setting Professional Modifier None Typical Low $4.47 Median $5.01 Typical High $8.13 | Professional | None | $4.47 | $5.01 | $8.13 |
Baylor Scott & White Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $52.48 | Facility | None | $8.13 | $8.13 | $52.48 |
Christus Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $17.78 Typical High $33.88 | Facility | None | $8.13 | $17.78 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $4.57 Median $6.31 Typical High $13.80 | Professional | None | $4.57 | $6.31 | $13.80 |
Health Smart Setting Facility Modifier None Typical Low $12.59 Median $12.59 Typical High $12.59 | Facility | None | $12.59 | $12.59 | $12.59 |
Health Smart Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $12.59 | Professional | None | $12.30 | $12.30 | $12.59 |
Lucent Health Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
Moda Health Setting Facility Modifier None Typical Low $7.24 Median $61.66 Typical High $112.20 | Facility | None | $7.24 | $61.66 | $112.20 |
Moda Health Setting Professional Modifier None Typical Low $4.90 Median $5.37 Typical High $10.23 | Professional | None | $4.90 | $5.37 | $10.23 |
Molina Setting Professional Modifier None Typical Low $6.17 Median $6.92 Typical High $6.92 | Professional | None | $6.17 | $6.92 | $6.92 |
Providence Setting Facility Modifier None Typical Low $6.61 Median $12.02 Typical High $33.88 | Facility | None | $6.61 | $12.02 | $33.88 |
Providence Setting Professional Modifier None Typical Low $4.57 Median $6.03 Typical High $12.30 | Professional | None | $4.57 | $6.03 | $12.30 |
United Setting Facility Modifier None Typical Low $2.95 Median $8.13 Typical High $31.62 | Facility | None | $2.95 | $8.13 | $31.62 |
United Setting Professional Modifier None Typical Low $4.07 Median $6.03 Typical High $8.13 | Professional | None | $4.07 | $6.03 | $8.13 |
Wellpoint Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | None | $4.07 | $4.07 | $4.07 |
10 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $2.75 Median $5.89 Typical High $21.88 | Facility | 52 · Reduced service | $2.75 | $5.89 | $21.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.10 Median $2.34 Typical High $8.91 | Facility | 53 · Discontinued | $1.10 | $2.34 | $8.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.45 Median $2.69 Typical High $4.90 | Professional | 52 · Reduced service | $2.45 | $2.69 | $4.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.98 Median $1.07 Typical High $1.95 | Professional | 53 · Discontinued | $0.98 | $1.07 | $1.95 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $3.09 Median $5.89 Typical High $21.88 | Facility | 52 · Reduced service | $3.09 | $5.89 | $21.88 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $1.23 Median $2.34 Typical High $8.91 | Facility | 53 · Discontinued | $1.23 | $2.34 | $8.91 |
Moda Health Setting Facility Modifier 91 · Repeat lab test Typical Low $56.23 Median $66.07 Typical High $81.28 | Facility | 91 · Repeat lab test | $56.23 | $66.07 | $81.28 |
Moda Health Setting Facility Modifier QW · Waived lab test Typical Low $61.66 Median $72.44 Typical High $229.09 | Facility | QW · Waived lab test | $61.66 | $72.44 | $229.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.45 Median $2.51 Typical High $3.98 | Professional | 52 · Reduced service | $2.45 | $2.51 | $3.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.98 Median $1.00 Typical High $1.58 | Professional | 53 · Discontinued | $0.98 | $1.00 | $1.58 |
Where Texas sits
The same service costs 7.1 times more in Minnesota than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Texas· 12th of 51
$12.30
MN $46.77MD $6.61
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.